Department of Cardiothoracic Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
Eur J Cardiovasc Nurs. 2013 Jun;12(3):284-92. doi: 10.1177/1474515112450244. Epub 2012 Jun 13.
Delirium is a temporary mental disorder, which occurs frequently among patients who undergo cardiac surgery. Delirium prediction and its associated prevention is essential. In a previous study, a risk checklist for delirium was developed.
The present study validated this checklist in a new, larger study population, and also investigated new risk factors.
Risk factors were obtained during the preoperative outpatient screening in 300 patients who underwent elective cardiac surgery. The Delirium Observation Screening scale was utilized pre- and postoperatively to assess delirium.
The incidence of delirium was 17.3%. A higher Euroscore, but not a disturbance in electrolytes, was confirmed as a predictor of postoperative delirium. Based on this study, a new risk model was constructed with the following risk factors: a higher Euroscore, older age (≥70 years), cognitive impairment, number of comorbidities, history of delirium, alcohol use and type of surgery. When using a probability of delirium of 20%, as predicted by the model, the sensitivity was 80.8% and the specificity 82.2%. The area under the curve was 0.89. With the revised delirium risk checklist, including seven new risk factors, patients with an increased risk of developing delirium following cardiac surgery could be identified more accurately.
谵妄是一种常见于接受心脏手术的患者的暂时性精神障碍。谵妄的预测及其相关预防至关重要。在之前的研究中，开发了一种用于预测谵妄的风险清单。
本研究旨在通过一项新的、更大的研究人群验证该清单，并调查新的危险因素。
在 300 名接受择期心脏手术的患者的术前门诊筛查中获取危险因素。使用谵妄观察筛选量表在术前和术后评估谵妄。
谵妄的发生率为 17.3%。较高的 Euroscore 但不是电解质紊乱被确认为术后谵妄的预测因素。基于这项研究，构建了一个新的风险模型，其中包含以下风险因素：较高的 Euroscore、年龄较大（≥70 岁）、认知障碍、合并症数量、谵妄史、酒精使用和手术类型。当使用该模型预测的谵妄概率为 20%时，敏感性为 80.8%，特异性为 82.2%。曲线下面积为 0.89。通过包含七个新的危险因素的修订后的谵妄风险清单，可以更准确地识别出心脏手术后有更高谵妄风险的患者。
